Epidemiological Profiles of Human Rabies Cases in Tunisia Between 2000 and 2022

Abstract

In Tunisia, rabies is endemic and represents a significant public health issue. The objectives of our study were to describe the epidemiological and clinical profiles of human rabies cases and report the risk factors associated with their occurrence. We conducted a retrospective, descriptive, and analytical study of human rabies cases confirmed at the Rabies Laboratory of the Pasteur Institute in Tunis from January 2000 to November 2022. Temporal-spatial, sociodemographic, and clinical variables and factors related to the exposure context, post-exposure, and response were collected for each patient. A total of 58 human rabies cases were identified. The governorates of Kairouan and Nabeul were the most affected, with a predominance of rural areas (77%, 34/44). The highest number of cases was recorded between May and November (74%, 43/58). The cases predominantly involved males, with the most affected age group being individuals aged from 31 to 59 years (30%, 17/57). Rabies transmission was primarily due to dogs (86%, 43/50) and a single bite (55%, 32/58). After an average incubation period of 60.3 days, hydrophobia and behavioral disturbances were the most common symptoms. This study demonstrates that the risk of human rabies remains present in Tunisia, highlighting the need to improve awareness and post-exposure prophylaxis practices.